Activists are trying to provide more food choices for people in poor communities. They’re also teaching them how to better spend precious “food dollars.”

For more than 30 years, the Hill District neighborhood in Pittsburgh lacked even a single supermarket. That changed with the opening of a Shop ‘n Save in 2013.

A new report from the RAND Corporation, a nonprofit research organization, says the store in the former “food desert” has had a positive effect on residents’ health as well as providing an economic boost to the community.

“Food deserts” are communities — usually in low-income areas — lacking grocery stores, farmers markets, and healthy food providers. Some studies suggest that half of all low-income neighborhoods in the United States are food deserts.

High-income communities have far greater access to healthy food than low-income communities, said Lauren Ornelas, founder and director of the Food Empowerment Project, in a recent interview with the Minnesota Public Radio show Marketplace.

“In fact, the high-income areas had 14 times more access to even frozen vegetables. So in communities of color and low-income communities, what you would typically find in the freezer section would be frozen pizzas or ice cream, not necessarily frozen vegetables,” she said.

The U.S. Department of Agriculture estimates that 23 million people, including more than 6 million children, live in food deserts that are more than a mile from a supermarket.

Of these, 11 million live in households with incomes at or below 200 percent of the poverty line. And more than 2 million people live in low-income rural areas that are more than 10 miles from a supermarket.

The RAND study, published in the December 2017 issue of the Annals of Epidemiology, found that 12 percent fewer Hill District residents reported facing food insecurity than in the similar Homewood neighborhood, which lacks a food store.

Hill District residents also had 10 percent fewer new cases of high cholesterol a year after the store opened, researchers concluded.

Participation in the Supplemental Nutrition Assistance Program (SNAP) declined by 12 percent in the Hill District compared to Homewood. Other related benefits included new employment opportunities, tax revenues, and increased customer traffic at nearby businesses.

These positive changes occurred despite the fact that RAND researchers found that residents didn’t necessarily buy healthier foods at the supermarket.

“Our findings suggest that locating a new supermarket in a low-income neighborhood may trigger health and economic improvements beyond just having access to healthier and more plentiful food offerings,” said Andrea Richardson, the study’s lead author and policy researcher at RAND. “Policymakers should consider these broad impacts of neighborhood investment that can translate into improved health for residents in underserved neighborhoods.”

The federal Healthy Food Financing Initiative is a public-private program that provides support and funding for efforts to bring new grocery stores, farmers markets, and other sources of fresh food to deprived communities.

In a partisan political era, such programs have received “surprisingly bipartisan support, especially because of the economic development factor,” Risa Waldoks, project manager of the National Campaign for Healthy Food Access at the Food Trust, told Healthline.

“These projects create jobs and anchor communities,” she said.

Plus, the issue is broadly relatable.

“Everyone has to eat,” Waldoks noted.

In Virginia, for example, a bill to create a $7 million Virginia Grocery Investment Fund was introduced by a Republican state senator, William Stanley, and has support across the political aisle.

“Some of my conservative friends have asked, ‘Is this a conservative bill?’ and I say yes, because if we are creating healthy choices for children, we’re allowing those children to grow up safe, happy, and healthy, then they are going to be great taxpayers to the Commonwealth, not tax burdens,” said Stanley at a January 11 press conference.

Supermarkets offer the greatest variety of healthy food options, but they’re just one way to address the food desert problem.

The Food Trust, a national nonprofit group that works to ensure access to affordable nutritious food, also helps run farmers markets in food desert communities.

In addition, it supports programs that give SNAP recipients more “bang for their buck” when they buy healthy food.

The latter is important, because even when fresh produce is available, it’s typically the most expensive type of food to buy.

The Food Trust also provides education in schools and communities about healthy eating and cooking. As researchers from the National Bureau of Economic Research have noted, simply opening a supermarket in a food desert has little or no impact on whether people buy healthier food.

Recently, a related term — “food swamps” — has been applied to communities that are oversaturated with unhealthy dining options, such as fast-food restaurants.

A recent Rudd Center for Food Policy and Obesity study found that a typical food swamp has four unhealthy eating options for every one healthy option.

Residents of such communities had higher obesity rates than non-swampy areas.

The Food Trust isn’t looking to shut down inner-city Burger King and McDonald’s restaurants, said Waldoks.

“People should have choices,” she said, “but we want to empower people with healthier choices, and not have to choose between a cheap fast-food option and an expensive healthy option.”

Often, communities described as food deserts and food swamps are one and the same.

The Food Trust has worked with groups from Philadelphia to San Francisco that help small markets in food desert communities stock and sell more produce.

Assistance includes everything from developing a business plan and education on how to maintain produce to even donating food racks, shelves, and refrigeration equipment.

A new study of San Francisco’s Tenderloin district found that the Healthy Retail SF initiative has resulted in more stores selling fresh fruit and vegetables than in any other area of the city.

Notably, stores in the neighborhood have increased their overall sales by 25 percent by offering healthier options to shoppers.

“By bringing together local merchants with the community and the city, we have shown that neighborhoods can take charge of their health and well-being, starting with their local stores,” said Dr. Tomás Aragón, health officer for the city of San Francisco.